수면 무호흡 증후군 환자에 있어서의 심장 리듬의 장애：비강내 지속성 양압호흡 치료법의 효과

초록

Background and Objectives：It has been demonstrated that sleep apnea syndrome predisposes to cardiac rhythmdisturbances and cardiovascular risks such as systemic hypertension. This study was conducted to investigate thetypes and frequency of cardiac arrhythmias which occurred during sleep and the effects of nasal continuous positiveairway pressure (nCPAP) therapy in the patients with sleep apnea syndrome. Subjects and Methods：The subjectswere 197 patients who were referred to the Sleep Research Center of Korea University Medical Center for polysomnographydue to snoring and sleep apnea from Jan. 1st 2000 to July 31st 2002. Of the 197 patients, 44 withsevere sleep apnea syndrome, whose respiratory disturbance index (RDI) exceeded 40/hr, were enrolled. Theirelectrograms on polysomnography before and after nCPAP therapy were analyzed. Results：Of the 44 subjects,32 (72.8%) showed cardiac arrhythmias. The types of arrhythmias were atrial premature beats (APBs, n=17),premature ventricular complexes (PVCs, n=15), sinus bradycardia (heart rate less than 40 per minute, n=6), sinuspause (n=1), and sinoatrial block (n=5). No fatal arrhythmias were identified. Most, 93.2%, of these arrhythmiasarose immediately after hypopneic or apneic episodes, and were accompanied by a significant decrease in SaO2,from 91.4% to 84.7% (p<0.05). After nCPAP therapy, these arrhythmias were completely disappeared in 11 patients(34.4%) and diminished in 15 (46.9%). Hypopneic or apneic episodes were preceded by cardiac arrhythmiasin only 36.4% with nCPAP (p<0.05 vs. before). Conclusion：Cardiac arrhythmias were demonstrated in 72.8% ofcases of severe sleep apnea syndrome, which were mostly benign and preceded by hypopneic or apneic episodes.nCPAP therapy decreased the frequency of hypopnea and apnea with elevated arterial O2 saturation, andeffectively eliminated cardiac arrhythmias.

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